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- Title
Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study.
- Authors
Mehra R; Benjamin EJ; Shahar E; Gottlieb DJ; Nawabit R; Kirchner HL; Sahadevan J; Redline S; Mehra, Reena; Benjamin, Emelia J; Shahar, Eyal; Gottlieb, Daniel J; Nawabit, Rawan; Kirchner, H Lester; Sahadevan, Jayakumar; Redline, Susan; Sleep Heart Health Study
- Abstract
<bold>Rationale: </bold>Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development.<bold>Objective: </bold>We postulate that the prevalence of nocturnal cardiac arrhythmias is higher among subjects with than without sleep-disordered breathing.<bold>Methods: </bold>The prevalence of arrhythmias was compared in two samples of participants from the Sleep Heart Health Study frequency-matched on age, sex, race/ethnicity, and body mass index: (1) 228 subjects with sleep-disordered breathing (respiratory disturbance index>or=30) and (2) 338 subjects without sleep-disordered breathing (respiratory disturbance index<5).<bold>Results: </bold>Atrial fibrillation, nonsustained ventricular tachycardia, and complex ventricular ectopy (nonsustained ventricular tachycardia or bigeminy or trigeminy or quadrigeminy) were more common in subjects with sleep-disordered breathing compared with those without sleep-disordered breathing: 4.8 versus 0.9% (p=0.003) for atrial fibrillation; 5.3 versus 1.2% (p=0.004) for nonsustained ventricular tachycardia; 25.0 versus 14.5% (p=0.002) for complex ventricular ectopy. Compared with those without sleep-disordered breathing and adjusting for age, sex, body mass index, and prevalent coronary heart disease, individuals with sleep-disordered breathing had four times the odds of atrial fibrillation (odds ratio [OR], 4.02; 95% confidence interval [CI], 1.03-15.74), three times the odds of nonsustained ventricular tachycardia (OR, 3.40; 95% CI, 1.03-11.20), and almost twice the odds of complex ventricular ectopy (OR, 1.74; 95% CI, 1.11-2.74). A significant relation was also observed between sleep-disordered breathing and ventricular ectopic beats/h (p<0.0003) considered as a continuous outcome.<bold>Conclusions: </bold>Individuals with severe sleep-disordered breathing have two- to fourfold higher odds of complex arrhythmias than those without sleep-disordered breathing even after adjustment for potential confounders.
- Publication
American Journal of Respiratory & Critical Care Medicine, 2006, Vol 173, Issue 8, p910
- ISSN
1073-449X
- Publication type
journal article
- DOI
10.1164/rccm.200509-1442oc